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“When you show people deepfakes and generative AI, a lot of times they come out of the experiment saying, ‘I just don’t trust anything anymore,’” says David Rand, a professor at MIT Sloan who studies the creation, spread and impact of misinformation.

The signs that an image is AI-generated are easy to miss for a user simply scrolling past, who has an instant to decide whether to like or boost a post on social media. And as generative AI continues to improve, it’s likely that such signs will be harder to spot in the future.

The combination of easily-generated fake content and the suspicion that anything might be fake allows people to choose what they want to believe, adds DiResta, leading to what she calls “bespoke realities.”

Examples of misleading content created by generative AI are not hard to come by, especially on social media

This problem, which has grown more acute in the age of generative AI, is known as the “liar’s dividend,

People’s attention is already limited, and the way social media works—encouraging us to gorge on content, while quickly deciding whether or not to share it—leaves us precious little capacity to determine whether or not something is true

“What our work suggests is that most regular people do not want to share false things—the problem is they are not paying attention,”

are now using its existence as a pretext to dismiss accurate information

The rapid adoption of many different AI tools means that we are now forced to question everything that we are exposed to in any medium, from our immediate communities to the geopolitical, said Hany Farid, a professor at the University of California, Berkeley who

If the crisis of authenticity were limited to social media, we might be able to take solace in communication with those closest to us. But even those interactions are now potentially rife with AI-generated fakes.

what sounds like a call from a grandchild requesting bail money may be scammers who have scraped recordings of the grandchild’s voice from social media to dupe a grandparent into sending money.

companies like Alphabet, the parent company of Google, are trying to spin the altering of personal images as a good thing. 

With its latest Pixel phone, the company unveiled a suite of new and upgraded tools that can automatically replace a person’s face in one image with their face from another, or quickly remove someone from a photo entirely.

Joseph Stalin, who was fond of erasing people he didn’t like from official photos, would have loved this technology.

In Google’s defense, it is adding a record of whether an image was altered to data attached to it. But such metadata is only accessible in the original photo and some copies, and is easy enough to strip out.

in the course of a lawsuit over the death of a man using Tesla’s “full self-driving” system, Elon Musk’s lawyers responded to video evidence of Musk making claims about this software by suggesting that the proliferation of “deepfakes” of Musk was grounds to dismiss such evidence. They advanced that argument even though the clip of Musk was verifiably real

To put our current moment in historical context, he notes that the PC revolution made it easy to store and replicate information, the internet made it easy to publish it, the mobile revolution made it easier than ever to access and spread, and the rise of AI has made creating misinformation a cinch. And each revolution arrived faster than the one before it.

Not everyone agrees that arming the public with easy access to AI will exacerbate our current difficulties with misinformation. The primary argument of such experts is that there is already vastly more misinformation on the internet than a person can consume, so throwing more into the mix won’t make things worse.

it’s not exactly reassuring, especially given that trust in institutions is already at one of the lowest points in the past 70 years, according to the nonpartisan Pew Research Center, and polarization—a measure of how much we distrust one another—is at a high point.

“What happens when we have eroded trust in media, government, and experts?” says Farid. “If you don’t trust me and I don’t trust you, how do we respond to pandemics, or climate change, or have fair and open elections? This is how authoritarianism arises—when you erode trust in institutions.”

The economy that Hickel envisions would cease to pursue growth, green or otherwise. Materials and energy will still be consumed, and waste generated, but at much lower levels. All impacts on the natural world will be tethered to the question, “Growth for whom, and to what ends?” In place of an individualistic consumer economy, Hickel’s post-growth economy would direct itself toward the creation of public goods that allow the many to live well—mass transit, health care—rather than to keep a few in luxury.

A growing body of research reveals an inverse relationship between “happiness” and growth beyond a certain point.

In the rich countries, general contentment peaked in 1950, when GDP and real per capita incomes were fractions of their present size (and inequality near modern historic lows); degrowthers posit that similar happiness levels will be reclaimed on the way back down the economic mountain

Hickel describes a post-growth economy defined by stability and equality, and the freedom and leisure possible when the economy is no longer subservient to the god of growth

He estimates that the U.S. economy could be scaled down by as much as 65 percent while still improving the lives of its citizens. This includes the metric most often tied to celebrations of endless growth: life expectancy.

degrowth will entail a steep reduction across a much wider range of high-energy consumer goods. Keeping a global economy within safe ecological limits is a zero-sum game.

When limited resources are directed toward clean energy infrastructure, public health care, and regenerative agriculture, it will still be possible to build and power modern 24-hour hospitals in every city, but not to have Xbox consoles, two-car garages, and giant appliances in every home.

would have to redefine it, too.

The post-growth economy could not succeed solely by redistributing wealth; it would have to redefine it, too.

He argues that short-term growth would have to continue in those countries that have still not achieved the basic levels of sanitation, infrastructure, and education needed for a decent standard of living, to close the gap. Their larger goal, meanwhile, would be to break free from their historical role as a source of natural resources and cheap labor for the north.

For degrowth to be just, global, and effective, the sharpest reduction in consumption will have to come from the north, where the greatest damage to the planet is currently being done

Ecological economists generally agree that the safe outer limit is eight tons

One person in a low-income country has a materials footprint of roughly two tons per year, a measure of total raw materials consumed, including those embodied in imports. In lower-middle–income countries, that number is four tons; in upper-middle–income countries, 12 tons. In the high-income nations of North America, Europe, and Asia, the number leaps to 28

The wealthiest 20 percent of the human population is responsible for 90 percent of “overshoot” carbon in the atmosphere (that is, a level of carbon that exceeds the limit needed to keep global temperature rise below 2 degrees Celsius)

The planet’s richest one percent has a carbon footprint twice the size of the poorest half of the world’s population combined

For the global north, degrowth not only starts at home, it starts with the biggest houses.

Less Is More doesn’t end in a poetic appreciation for nature’s majesty, but by teasing out its implications for the political project of preserving a habitable planet. Hickel devotes much of the book to explaining that degrowth must be central to this project, promising not just survival, but real democracy, social abundance, and liberation.

Both involve broad social shifts away from private consumption and toward the production of shared public goods.

This beautiful coincidence overlaps with policy programs like the Green New Deal in important way

In July 1979, shortly after installing a set of solar panels over the West Wing, Jimmy Carter did something peculiar for a peacetime president. He asked Americans to sacrifice: to consume less, take public transit more, value community over material things, and buy bonds to fund domestic energy development, including solar

Next to Schumacher’s “Buddhist economics,” Debsian socialism was reformist tinkering. Schumacher didn’t see liberation as a matter of reshuffling the ownership and management structures of the smokestack-powered growth economy. He believed a deeper transformation was needed to maintain a livable planet. This would require new socioecological blueprints “designed for permanence.” As the left and the right battled for control over growth’s levers and spoils, Schumacher pointed out how both had become blind to the rise of growth as its own self-justifying, pan-ideological religion; its patterns of production and consumption, he observed, required “a degree of violence” that did not “fit into the laws of the universe.”

They determined that infinite growth was, in fact, impossible on a finite planet. Barring a major course correction, the team projected, growthism would result in an ecological systems breakdown sometime in the middle of the twenty-first century

This warning, detailed in the 1972 bestseller The Limits to Growth, has aged better than the scorn heaped on it

We are now witnessing what appears to be the beginnings of the collapse predicted nearly 50 years ago

In his new book, Less Is More, Jason Hickel, an anthropologist and journalist, attempts to bring a comprehensive critique of growth closer to the center of the conversation, arguing through a sweeping history of capitalism that it’s uncontrolled growth, not its controlled arrest and reversal, that is the preposterous concept.

This economic and political revolution was reinforced by a complementary scientific one that displaced the lingering animist cosmology of pre-capitalist Europe. The dualism of Francis Bacon and Descartes held reason to be distinct from and superior to matter.

The idea of limitless growth is a relatively recent one. In Less Is More, Hickel traces its origins to the enclosure of the European commons in the sixteenth century

Starving refugees were scattered and forced into a new economy defined by neo-feudal servitude and wage labor. Landowners, meanwhile, began amassing great stores of surplus wealth.

By the mid-1800s, a new “science” had arisen from these assumptions. Neoclassical economics fully abstracted the economy from the natural world. The economy was geared not toward the creation of a happy and prosperous society, but toward the perpetual growth of wealth as its own end, achieved in an inherently virtuous cycle of converting labor and resources into capital, to be accumulated and reinvested in faster and more productive conversions of labor and resources

This ideology subsumed and profaned notions about progress and morality held by the classical economists, until eventually the field even l

This process unfolded despite repeated warnings along the way. Classical economists like John Stuart Mill and, to a lesser extent, Adam Smith not only acknowledged the existence of natural limits to growth, but saw economic development as a phase; at some point, they believed, nations would create enough wealth to pursue other definitions of progres

the caveats issued by Simon Kuznets, father of the concept adopted in the twentieth century as growth’s universal and signature metric: gross domestic product. Kuznets, Hickel points out, “warned that we should never use GDP as a normal measure of economic progress,” because GDP does not distinguish between productive and destructive behavior

Most people encounter the growth debate, if they encounter it at all, through the idea of “green growth.

This is a vision for our collective future based on the belief that technological advance will drastically reduce the amount of raw materials needed to sustain growth—a process known as dematerialization—and “decouple” growing GDP from its ecological impacts.

boosters of the idea point to the transition by rich countries from manufacturing to service-based economies, as well as efficiency gains in energy and in the use of materials

The belief that green growth will save us, also known as “ecomodernism” or “ecopragmatism,” has become a trendy article of faith among elites who acknowledge climate change and the dangers of breaching ecological boundaries

n 2017, Barack Obama threw his support behind the idea in an article for Science magazine, maintaining that signs of decoupling in major economies “should put to rest the argument that combatting climate change requires accepting lower growth or a lower standard of living.”

The argument that capitalism can grow itself out of the present crisis may be soothing to those who like the world as it is. It also relies on the kind of accounting tricks and rejection of reality

By only counting the emissions created within a country that imports most of its cars, washing machines, and computers, you end up pushing the emissions related to their production off the books. When you factor them back in, the picture is much less green. A number of recent studies show no evidence of meaningful decoupling—in energy or materials—even as the world increases its use of renewable energy and finds ways to use some materials more efficiently.

Green growth, Hickel concludes, is an ecologically incoherent “fairy tale.”

consider what the ecomodernist position asks us to believe. The current system requires annual growth of roughly 3 percent to avoid the shock of recession. This means doubling the size of the economy every 23 years

he economy of 2000 must be 20 times larger in the year 2100, and 370 times larger in the year 2200.

Hickel is less interested in the macroeconomic details of this future than are growth critics based in economics departments, like Tim Jackson and Kate Raworth, and more focused on the leisure, security, and general human flourish

he makes an alluring case that degrowth does not require anything like the “command-and-control fiasco of the Soviet Union, or some back-to-the-caves, hair-shirted disaster of voluntary impoverishment.”

Attaining the benefits of the post-growth economy would, however, require what the present consumer society considers “sacrifices.

it’s not clear how many of them are ready to give up its superficial pleasures enabled by consumer debt

Among nations, there’s also the question of fairness: Wouldn’t it be unjust to impose degrowth across the world, when it’s disproportionately the countries of the global north that have spent centuries burning through the planet’s resources?

This output tracks to the one percent’s share of global wealth—a number equal to the GDP of the bottom 169 countries.

Even if you accept the argument that inequality would be best addressed by more centuries of trickle-down growth, you keep running up against the simple fact of its impossibility. Even just one more century of growth—which so far has shown no sign of taking a less destructive form—will require multiple earths

Hickel is serious about bringing the system critiques of E.F. Schumacher and others out of their traditional cloisters and into the streets, and has sought allies in this effort

emphasize what Hickel calls the “beautiful coincidence” of degrowth: that “what we need to do to survive is the same as what we need to do to have better lives.”

Both are internationalist in outlook, and see the world through a lens of climate justice as well as climate equilibrium.

that is, communicating the many benefits of moving beyond the insecurity and terrors of the current system, and building a new society that is sustainable, stable, democratic, and fundamentally better in every way.

It’s hard to wrap your mind around men having fond memories of brutal treatment, but Marshall explained that it was not so simple as looking back on one event of hazing and condemning the entire system: “It’s almost a rational choice of thinking, ‘This was my entry into an oil and gas or real estate job. This is how I got into private equity or politics. And there’s always going to be a group of people who are always going to look out for me whenever I need a favor.’

And for those in the bubble, there’s an attitude that the more intense the hazing experience was, the better story you might have, the more other men will respect you.

Above all, Marshall’s book explores coming of age in a world that will not hold you accountable, even by law enforcement: “When you can get away with anything, it does lead to an arrested development. If you drive drunk and don’t go get a DUI, how do you learn not to drive drunk? If you commit a much worse crime and don’t get punished, how do you learn not to?”

All the men involved in Kappa Alpha’s drug ring were white – in fact, they were often described by their fellow students at the College of Charleston and law enforcement as looking like normal white boys. They were protected by wealthy parents, the best lawyers, and a “boys will be boys” culture. They were emboldened to test the boundaries of their privilege, and they came out with barely a scratch.

One of the most fundamental problems with recycling is that we don’t really know how much of it actually happens because of an opaque global system that too often relies on measuring the material that arrives at the front door of the facility rather than what comes out

What we do know is that with plastics, at least, the amount being recycled is much less than most of us assumed.

According to the Environmental Protection Agency, two of the most commonly used plastics in America — PET (used in soda bottles) and HDPE (used in milk jugs, among other things) — are “widely recycled,” but the rate is really only about 30 percent

Other plastics, like soft wraps and films, sometimes called No. 4 plastics, are not widely accepted in curbside collections.

The E.P.A. estimates that just 2.7 percent of polypropylene — the hard plastic known as No. 5, used to make furniture and cleaning bottles — was reprocessed in 2018

Crunch the sums, and only around 10 percent of plastics in the United States is recycle

the landfill-happy United States is far worse at recycling than other major economies. According to the E.P.A., America’s national recycling rate, just 32 percent, is lower than Britain’s 44 percent, Germany’s 48 percent and South Korea’s 58 percent.

the scientific research over decades has repeatedly found that in almost all cases, recycling our waste materials has significant environmental benefits

We need clearer labeling of what is and is not actually recyclable and transparency around true recycling rates

Recycling steel, for example, saves 72 percent of the energy of producing new steel; it also cuts water use by 40 percent

Recycling a ton of aluminum requires only about 5 percent of the energy and saves almost nine tons of bauxite from being hauled from mines

Even anti-plastics campaigners agree that recycling plastics, like PET, is better for the climate than burning them — a likely outcome if recycling efforts were to be abandoned.

The economic perks are significant, too. Recycling creates as many as 50 jobs for every one created by sending waste to landfills; the E.P.A. estimates that recycling and reuse accounted for 681,000 jobs in the United States alone.

That’s even more true in the developing world, where waste pickers rely on recycling for income.

before we abandon recycling, we should first try to fix it

Companies should be phasing out products that can’t be recycled and designing more products that are easier to recycle and reuse rather than leaving sustainability to their marketing departments.

Lawmakers can help by passing new laws, as cities like Seattle and San Francisco have done, to help increase recycling rates and drive investment into the sector.

Governments can also ban or restrict many problematic plastics to reduce the amount of needless plastics in our everyday lives, for instance in food packaging

According to a 2015 analysis by scientists at the University of Southampton in England, recycling a majority of commonly tossed-out waste materials resulted in a net reduction in greenhouse gas emissions

Greater safety regulations are needed to reduce toxic chemical contents and microplastic pollution caused by the recycling process.

consumers can do their bit by buying recycled products (and buying less and reusing more).

Yes, recycling is broken, but abandon it too soon, and we risk going back to the system of decades past, in which we dumped and burned our garbage without care, in our relentless quest for more. Do that, and like the recycling symbol itself, we really will be going in circles.

it is necessary to strip away the irrelevancies in which this controversy is usually wrapped up.

The enemies of intellectual liberty always try to present their case as a plea for discipline versus individualism.

The issue truth-versus-untruth is as far as possible kept in the background.

the writer who refuses to sell his opinions is always branded as a mere egoist, He is accused, that is, either of wanting to shut himself up in an ivory tower, or of making an exhibitionist display of his own personality, or of resisting the inevitable current, of history in an attempt to cling to unjustified privileges.

Each of them tacitly claims that “the truth” has already been revealed, and that the heretic, if he is not simply a fool, is secretly aware of “the truth” and merely resists it out of selfish motives.

Freedom of the intellect means the freedom to report what one has seen, heard, and fell, and not to be obliged to fabricate imaginary facts and feelings.

known facts are suppressed and distorted to such an extent as to make it doubtful whether a true history of our times can ever be written.

A totalitarian state is in effect a theocracy, and its ruling caste, in order to keep its position, has to be thought of as infallible. But since, in practice, no one is infallible, it is frequently necessary to rearrange past events in order to show that this or that mistake was not made, or that this or that imaginary triumph actually happened

Then, again, every major change in policy demands a corresponding change of doctrine and a revaluation of prominent historical figures. This kind of thing happens everywhere, but clearly it is likelier to lead to outright falsification in societies where only one opinion is permissible at any given moment.

The friends of totalitarianism in England usually tend to argue that since absolute truth is not attainable, a big lie is no worse than a little lie. It is pointed out that all historical records are biased and inaccurate, or, on the other hand, that modem physics has proved that what seems to us the real world is an illusion, so that to believe in the evidence of one’s senses is simply vulgar philistinism.

But the Piers became plagued by a series of health issues, which made traveling to Arlington more difficult. Knowing they couldn't see Noah's grave as often as they wished, Mark erected a memorial on their property. And in recent years, the Piers family — all nine children and 12 grandchildren — have gathered at Mark and Vikki's on Memorial Day. They don't see it as a holiday or an event to be celebrated, but more of a day of reflection. They hang the American flag high and write letters to Noah on red balloons. They play games with the kids and cook up some of Noah's favorite foods and share stories.

It pains Mark and Vikki to have been away from the cemetery for so long. But they know they will go back as soon as possible. Vikki said she hopes that she and Mark can manage to make the journey for Noah's birthday on July 28; he would have turned 38 this year. "It breaks my heart," Vikki said. "My heart is in Arlington. It is. I'm not physically there, but I do wish I could go and just touch the ground and sit with him."

The first missile launched on Wednesday by North Korea appeared to have been an ICBM, South Korean defense officials said. But it flew only 224 miles, the officials said, indicating that North Korea did not want to launch the missile on a full ICBM trajectory over the Pacific while Mr. Biden was in the air on his way back to Washington after a visit to Seoul and Tokyo.

The second missile launched on Wednesday apparently failed because it “disintegrated” after reaching an altitude of 12 miles, the South Korean officials said. The third projectile was a short-range ballistic missile.

The missile launches on Wednesday were a strong signal that North Korea was embarking on a new cycle of tensions in the Korean Peninsula despite the country’s first reported outbreak of the coronavirus. It also constituted North Korea’s public reaction to Mr. Biden’s trip to the region, where he met with the leaders of South Korea and Japan and vowed to step up measures, including joint military exercises, to help deter the growing nuclear and missile threat from the North.

But like his conservative predecessors, he attached an important caveat: Such economic largess would be possible only “if North Korea genuinely embarks on a process to complete denuclearization.”

In the same speech, he seemed to take a page from the playbook of President Vladimir V. Putin of Russia when he warned that his nuclear arsenal was not just to deter foreign invasion, but also to be used “if any forces try to violate the fundamental interests of our state.”

“North Korea continues to improve, expand and diversify its conventional and nuclear missile capabilities, posing an increasing risk to the U.S. homeland and U.S. forces, allies, and partners in the region,” John Plumb, the U.S. assistant secretary of defense for space policy, told the Senate Armed Services Committee this month. “Most of North Korea’s ballistic missiles have an assessed capability to carry nuclear payloads.”

Besides teenage girls, another new group was referred to us: young people from the inpatient psychiatric unit, or the emergency department, of St. Louis Children’s Hospital. The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more. Often they were already on a fistful of pharmaceuticals.

Being put on powerful doses of testosterone or estrogen—enough to try to trick your body into mimicking the opposite sex—-affects the rest of the body. I doubt that any parent who's ever consented to give their kid testosterone (a lifelong treatment) knows that they’re also possibly signing their kid up for blood pressure medication, cholesterol medication, and perhaps sleep apnea and diabetes. 

There are rare conditions in which babies are born with atypical genitalia—cases that call for sophisticated care and compassion. But clinics like the one where I worked are creating a whole cohort of kids with atypical genitals—and most of these teens haven’t even had sex yet. They had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist.

Other girls were disturbed by the effects of testosterone on their clitoris, which enlarges and grows into what looks like a microphallus, or a tiny penis. I counseled one patient whose enlarged clitoris now extended below her vulva, and it chafed and rubbed painfully in her jeans. I advised her to get the kind of compression undergarments worn by biological men who dress to pass as female. At the end of the call I thought to myself, “Wow, we hurt this kid.”

How little patients understood what they were getting into was illustrated by a call we received at the center in 2020 from a 17-year-old biological female patient who was on testosterone. She said she was bleeding from the vagina. In less than an hour she had soaked through an extra heavy pad, her jeans, and a towel she had wrapped around her waist. The nurse at the center told her to go to the emergency room right away.

We found out later this girl had had intercourse, and because testosterone thins the vaginal tissues, her vaginal canal had ripped open. She had to be sedated and given surgery to repair the damage. She wasn’t the only vaginal laceration case we heard about.

Bicalutamide is a medication used to treat metastatic prostate cancer, and one of its side effects is that it feminizes the bodies of men who take it, including the appearance of breasts. The center prescribed this cancer drug as a puberty blocker and feminizing agent for boys. As with most cancer drugs, bicalutamide has a long list of side effects, and this patient experienced one of them: liver toxicity. He was sent to another unit of the hospital for evaluation and immediately taken off the drug. Afterward, his mother sent an electronic message to the Transgender Center saying that we were lucky her family was not the type to sue.

Here’s an example. On Friday, May 1, 2020, a colleague emailed me about a 15-year-old male patient: “Oh dear. I am concerned that [the patient] does not understand what Bicalutamide does.” I responded: “I don’t think that we start anything honestly right now.”

There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are. 

Many encounters with patients emphasized to me how little these young people understood the profound impacts changing gender would have on their bodies and minds. But the center downplayed the negative consequences, and emphasized the need for transition. As the center’s website said, “Left untreated, gender dysphoria has any number of consequences, from self-harm to suicide. But when you take away the gender dysphoria by allowing a child to be who he or she is, we’re noticing that goes away. The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.” 

When a female takes testosterone, the profound and permanent effects of the hormone can be seen in a matter of months. Voices drop, beards sprout, body fat is redistributed. Sexual interest explodes, aggression increases, and mood can be unpredictable. Our patients were told about some side effects, including sterility. But after working at the center, I came to believe that teenagers are simply not capable of fully grasping what it means to make the decision to become infertile while still a minor.

To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription. 

The doctors privately recognized these false self-diagnoses as a manifestation of social contagion. They even acknowledged that suicide has an element of social contagion. But when I said the clusters of girls streaming into our service looked as if their gender issues might be a manifestation of social contagion, the doctors said gender identity reflected something innate.

Frequently, our patients declared they had disorders that no one believed they had. We had patients who said they had Tourette syndrome (but they didn’t); that they had tic disorders (but they didn’t); that they had multiple personalities (but they didn’t).

The girls who came to us had many comorbidities: depression, anxiety, ADHD, eating disorders, obesity. Many were diagnosed with autism, or had autism-like symptoms. A report last year on a British pediatric transgender center found that about one-third of the patients referred there were on the autism spectrum.

This concerned me, but didn’t feel I was in the position to sound some kind of alarm back then. There was a team of about eight of us, and only one other person brought up the kinds of questions I had. Anyone who raised doubts ran the risk of being called a transphobe. 

I certainly saw this at the center. One of my jobs was to do intake for new patients and their families. When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school. 

Until 2015 or so, a very small number of these boys comprised the population of pediatric gender dysphoria cases. Then, across the Western world, there began to be a dramatic increase in a new population: Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone. 

Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment. The center’s physician co-directors were essentially the sole authority.

At first, the patient population was tipped toward what used to be the “traditional” instance of a child with gender dysphoria: a boy, often quite young, who wanted to present as—who wanted to be—a girl. 

During the four years I worked at the clinic as a case manager—I was responsible for patient intake and oversight—around a thousand distressed young people came through our doors. The majority of them received hormone prescriptions that can have life-altering consequences—including sterility. 

I left the clinic in November of last year because I could no longer participate in what was happening there. By the time I departed, I was certain that the way the American medical system is treating these patients is the opposite of the promise we make to “do no harm.” Instead, we are permanently harming the vulnerable patients in our care.

Today I am speaking out. I am doing so knowing how toxic the public conversation is around this highly contentious issue—and the ways that my testimony might be misused. I am doing so knowing that I am putting myself at serious personal and professional risk.

Almost everyone in my life advised me to keep my head down. But I cannot in good conscience do so. Because what is happening to scores of children is far more important than my comfort. And what is happening to them is morally and medically appalling.

For almost four years, I worked at The Washington University School of Medicine Division of Infectious Diseases with teens and young adults who were HIV positive. Many of them were trans or otherwise gender nonconforming, and I could relate: Through childhood and adolescence, I did a lot of gender questioning myself. I’m now married to a transman, and together we are raising my two biological children from a previous marriage and three foster children we hope to adopt. 

The center’s working assumption was that the earlier you treat kids with gender dysphoria, the more anguish you can prevent later on. This premise was shared by the center’s doctors and therapists. Given their expertise, I assumed that abundant evidence backed this consensus. 

All that led me to a job in 2018 as a case manager at The Washington University Transgender Center at St. Louis Children's Hospital, which had been established a year earlier. 

the Telluride workshops were being organized by two college-age students, filled with the spirit of the times

From what I gleaned, they involved crudely conveying certain dogmatic assertions, no matter what topic the workshops were ostensibly about:Experiencing hardship conveys authority. There is no hierarchy of oppressions—except for anti-black oppression, which is in a class of its own. Trust black women.Prison is never the answer.Black people need black space.Allyship is usually performative.All non-black people, and many black people, are guilty of anti-blackness.There is no way out of anti-blackness.

It is tempting to add: Such is life. Such is democratic life. We each have different, partial knowledge. We each get things wrong, over and over. At our best, we enter the fray by listening to each other and complementing and challenging the insights of our fellows. In the process, over years, decades, we are oriented toward justice and truth.

Specific words, phrases, arguments, and images from a text offer essential friction for conversation, holding seminar participants accountable to something concrete.

The seminar assumes that each student has innate intelligence, even as we come from different backgrounds, have different amounts and sorts of knowledge, and different skills. We can each be formed best if we take advantage of our differing insights to push each other, over time, again and again. When this practice is occasioned by carefully curated texts—not exclusively “great books,” but texts that challenge each other and us as they probe issues of essential importance—a seminar succeeds.

Each intervention in a seminar is incomplete, and gets things wrong. Each subsequent intervention is also incomplete, and also gets things wrong. But there are plenty of insights and surprises, for each participant looks at a text with different eyes

By its nature, a seminar requires patience. Day by day, one intervention builds on another, as one student notices what another student overlooked, and as the professor guides the discussion toward the most important questions

The effects on the seminar were quick and dramatic. During the first week, participation was as you would expect: There were two or three shy students who only spoke in partner or small-group work, two or three outspoken students, and the rest in the middle. One of the black students was outspoken, one was in the middle, and one was shy. By the second week of the seminar, the two white students were effectively silent. Two of the Asian-American students remained active (the ones who would soon be expelled), but the vast majority of interventions were from the three black students. The two queer students, one Asian and one white, were entirely silent

“Two of the Asian-American students would be expelled from the program.”In the 2022 anti-racism workshops, the non-black students learned that they needed to center black voices—and to shut up.

If the seminar is slow food, the anti-racist workshop put on by college-age students is a sugar rush. All the hashtags are there, condensed, packaged, and delivered from a place of authority. The worst sort of anti-racist workshop simply offers a new language for participants to echo—to retweet out loud.

In their “transformative-justice” workshop, my students learned to name “harms.”

In the language of the anti-racism workshop, a harm becomes anything that makes you feel not quite right. For a 17-year-old at a highly selective, all-expenses-paid summer program, newly empowered with the language of harm, there are relatively few sites at which to use this framework. My seminar became the site at which to try out—and weaponize—this language.

John McWhorter asserts that anti-racism is a new religion. It was an idea I quickly dismissed. Last summer, I found anti-racism to be a perversion of religion: I found a cult

the features of cults have become familiar in popular culture. There is sleep deprivation. Ties to the outside world are severed. The sense of time collapses, with everything cult-related feeling extremely urgent. Participants are emotionally battered. In this weakened state, participants learn about and cling to dogmatic beliefs. Any outsider becomes a threat.

The feature of a cult that seems to be missing from this story is a charismatic leader, enforcing the separation of followers from the world, creating emotional vulnerability, and implanting dogma. Enter Keisha

Pushing anti-racism to its limits, what we reach isn’t just hollow doctrine, but abuse: Pathological relationships that cut us off from the world, from the give-and-take of reasons and feelings unfolding over time that makes up life in the world.

We see this crystal clear in the paradoxes that I encountered

The experience was supposed to be organized around a “transformative justice,” rather than a punitive model, yet the community managed to expel two of its members.

Students continually voiced their desire to find practical actions to help change the world, but after four weeks, they had learned to say that anti-blackness is so foundational, the world could never change

The students wanted freedom, for themselves and for all, but they started to say that the only route to freedom is indoctrination: having me tell them what to think.

Saddest of all, for me, was hearing what the black students said. They needed extra help, they were struggling to understand anything from the readings, and they couldn’t even know what questions to ask unless they had guidance—first Keisha said this, then the black students said it, then their “allies” repeated it in solidarity with them

The book recounts four peak periods in the conflict between white Alabamians and the federal government: the wild rush, in the early 19th century, to seize and settle lands that belonged to the Creek Nation; Reconstruction; the reassertion of white supremacy under Jim Crow; and the attempts of Wallace and others to nullify the civil rights reforms of the 1950s and 1960s.

Throughout, as Cowie reveals, white Southerners portrayed the oppression of Black people and Native Americans not as a repudiation of freedom, but its precondition, its very foundation.

Following the election of Ulysses S. Grant in 1868 and the ratification of the 14th and 15th Amendments, the federal presence in the South was finally robust. So was the spirit of local defiance. In post-bellum Barbour County, Cowie writes, “peace only prevailed for freed people when federal troops were in town” — and then only barely

White men did all this in Barbour County, by design and without relent, and Cowie’s account of their acts is unsparing. His narrative is immersive; his characters are vividly rendered, whether familiar figures like Andrew Jackson or mostly forgotten magnates like J.W. Comer, a plantation owner who became, in the late 19th century, the architect of a vast, sadistic and extremely lucrative system of convict labor

Thus were white men, in the words of the scholar Orlando Patterson, whom Cowie quotes, “free to brutalize.” Thus were they free “to plunder and lay waste and call it peace, to rape and humiliate, to invade, conquer, uproot and degrade.”

the chaos in Alabama offended Jackson’s sense of discipline and made a mockery of his treaties with the Creeks. Beginning in 1832, and in fits and starts over the following year, federal troops looked to turn back or at least contain the white wave. Instead, their presence touched off a series of violent reprisals, created a cast of martyrs and folk heroes, and gave rise to the mythology of white victimization. Self-rule and local authority — rhetorical wrapping for this will to power — had become articles of faith, fervid as any religious belief.

The federal government is a character here, too — sometimes in a central role, sometimes remote to the point of irrelevance, and all too often feckless in the defense of a more inclusive, affirmative model of freedom.

When Grant stepped up the enforcement of voting rights, whites in Eufaula, Barbour County’s largest town, massacred Black citizens and engaged in furious efforts to manipulate or overturn elections. As in the 1830s, the federal government showed little stamina for the struggle. Republican losses in 1874 augured another retreat, this time for the better part of a century. In the vacuum, Cowie explains, emerged “the neoslavery of convict leasing, the vigilante justice of lynching, the degradation and debt of sharecropping and the official disenfranchisement of Blacks” under Jim Crow.

Wallace, as Cowie makes clear, had bigger ambitions. Instinctively, he knew that his brand of politics had an audience anywhere that white Americans were under strain and looking for someone to blame. Wallace became the sneering face of the backlash against the Civil Rights Act and the Voting Rights Act, against any law or court ruling or social program that aimed to include Black Americans more fully in our national life. Racism was central to his appeal, yet its common note was grievance; the common enemies were elites, the press and the federal government. “Being a Southerner is no longer geographic,” he declared in 1964, during the first of his four runs for the White House. “It’s a philosophy and an attitude.”

That attitude, we know, is pervasive now — a primal, animating principle of conservative politics. We hear it in conspiracy theories about the “deep state”; we see it in the actions of Republican officials like Gov. Ron DeSantis of Florida, who built a case for his re-election in 2022 by banning — in the name of “individual freedom” — classroom discussions of gender, sexuality and systemic racism.

In explaining how we got here, “Freedom’s Dominion” emphasizes race above economics, but this seems fitting. The fixation on the free market, so long a defining feature of the Republican Party, has loosened its hold; taxes and regulations do not boil the blood as they once did. In their place is a stew of resentments as raw as any since George Wallace stirred the pot.

But the legal wrangling to just get the courts to treat crypto as a set of speculative instruments regulated under securities law made the law moot

In May of 2022, a year after Gensler began trying to do something about Terra/Luna, Kwon’s scheme blew up. In a comically-too-late-to-matter gesture, an appeals court then said that the SEC had the right to compel information from Kwon’s now-bankrupt scheme. It is absolute lunacy that well-settled law, like the ability for the SEC to investigate those in the securities business, is now being re-litigated.

many crypto ‘enthusiasts’ watching Gensler discuss regulation with his predecessor “called for their incarceration or worse.”

it wasn’t just the courts who were an impediment. Gensler wasn’t the only cop on the beat. Other regulators, like those at the Commodities Futures Trading Commission, the Federal Reserve, or the Office of Comptroller of the Currency, not only refused to take action, but actively defended their regulatory turf against an attempt from the SEC to stop the scams.

Behind this was the fist of political power. Everyone saw the incentives the Senate laid down when every single Republican, plus a smattering of Democrats, defeated the nomination of crypto-skeptic Saule Omarova in becoming the powerful bank regulator at the Comptroller of the Currency

Instead of strong figures like Omarova, we had a weakling acting Comptroller Michael Hsu at the OCC, put there by the excessively cautious Treasury Secretary Janet Yellen. Hsu refused to stop bank interactions with crypto or fintech because, as he told Congress in 2021, “These trends cannot be stopped.”

It’s not just these regulators; everyone wanted a piece of the bureaucratic pie. In March of 2022, before it all unraveled, the Biden administration issued an executive order on crypto. In it, Biden said that virtually every single government agency would have a hand in the space.

That’s… insane. If everyone’s in charge, no one is.

And behind all of these fights was the money and political prestige of some most powerful people in Silicon Valley, who were funding a large political fight to write the rules for crypto, with everyone from former Treasury Secretary Larry Summers to former SEC Chair Mary Jo White on the payroll.

(Even now, even after it was all revealed as a Ponzi scheme, Congress is still trying to write rules favorable to the industry. It’s like, guys, stop it. There’s no more bribe money!)

Moreover, the institution Gensler took over was deeply weakened. Since the Reagan administration, wave after wave of political leader at the SEC has gutted the place and dumbed down the enforcers. Courts have tied up the commission in knots, and Congress has defanged it

Under Trump crypto exploded, because his SEC chair Jay Clayton had no real policy on crypto (and then immediately went into the industry after leaving.) The SEC was so dormant that when Gensler came into office, some senior lawyers actually revolted over his attempt to make them do work.

In other words, the regulators were tied up in the courts, they were against an immensely powerful set of venture capitalists who have poured money into Congress and D.C., they had feeble legal levers, and they had to deal with ‘crypto enthusiasts' who thought they should be jailed or harmed for trying to impose basic rules around market manipulation.

The bottom line is, Gensler is just one regulator, up against a lot of massed power, money, and bad institutional habits. And we as a society simply made the choice through our elected leaders to have little meaningful law enforcement in financial markets, which first became blindingly obvious in 2008 during the financial crisis, and then became comical ten years later when a sector whose only real use cases were money laundering

, Ponzi scheming or buying drugs on the internet, managed to rack up enough political power to bring Tony Blair and Bill Clinton to a conference held in a tax haven billed as ‘the future.’

It took a few years, but New Dealers finally implemented a workable set of securities rules, with the courts agreeing on basic definitions of what was a security. By the 1950s, SEC investigators could raise an eyebrow and change market behavior, and the amount of cheating in finance had dropped dramatically.

By 1935, the New Dealers had set up a new agency, the Securities and Exchange Commission, and cleaned out the FTC. Yet there was still immense concern that Roosevelt had not been able to tame Wall Street. The Supreme Court didn’t really ratify the SEC as a constitutional body until 1938, and nearly struck it down in 1935 when a conservative Supreme Court made it harder for the SEC to investigate cases.

Institutional change, in other words, takes time.

It’s a lesson to remember as we watch the crypto space melt down, with ex-billionaire Sam Bankman-Fried

It’s not like perfidy in crypto was some hidden secret. At the top of the market, back in December 2021, I wrote a piece very explicitly saying that crypto was a set of Ponzi schemes. It went viral, and I got a huge amount of hate mail from crypto types

one of the more bizarre aspects of the crypto meltdown is the deep anger not just at those who perpetrated it, but at those who were trying to stop the scam from going on. For instance, here’s crypto exchange Coinbase CEO Brian Armstrong, who just a year ago was fighting regulators vehemently, blaming the cops for allowing gambling in the casino he helps run.

FTX.com was an offshore exchange not regulated by the SEC. The problem is that the SEC failed to create regulatory clarity here in the US, so many American investors (and 95% of trading activity) went offshore. Punishing US companies for this makes no sense.

Donor-advised funds are categorized by law as public charities, rather than private foundations, so they have no payout requirements and few disclosure requirements.

And wealthy residents of Silicon Valley are donating large sums to such funds

critics say that in part because of its structure as a warehouse of donor-advised funds, the Silicon Valley Community Foundation has not had a positive impact on the community it is meant to serve. Some people I talked to say the foundation has had little interest in spending money, because its chief executive, Emmett Carson, who was placed on paid administrative leave after the Chronicle’s report, wanted it to be known that he had created one of the biggest foundations in the country. Carson was “aggressive” about trying to raise money, but “unaggressive about suggesting what clients would do with it,”

“Most of us in the local area have seen our support from the foundation go down and not up,” he said.

The amount of money going from the Silicon Valley Community Foundation to the nine-county Bay Area actually dropped in 2017 by 46 percent, even as the amount of money under management grew by 64 percent, to $13.5 billion

“They got so drunk on the idea of growth that they lost track of anything smacking of mission,” he said. It did not help perceptions that the foundation opened offices in New York and San Francisco at the same time local organizations were seeing donations drop.

The foundation now gives her organization some grants, but they don’t come from the donor-advised funds, she told me. “I haven’t really cracked the code of how to access those donor-advised funds,” she said. Her organization had been getting between $50,000 and $100,000 a year from United Way that it no longer gets, she said,

Rob Reich, the co-director of the Stanford Center on Philanthropy and Civil Society, set up a donor-advised fund at the Silicon Valley Community Foundation as an experiment. He spent $5,000—the minimum amount accepted—and waited. He received almost no communication from the foundation, he told me. No emails or calls about potential nonprofits to give to, no information about whether the staff was out looking for good opportunities in the community, no data about how his money was being managed.

One year later, despite a booming stock market, his account was worth less than the $5,000 he had put in, and had not been used in any way in the community. His balance was lower because the foundation charges hefty fees to donors who keep their money there. “I was flabbergasted,” he told me. “I didn’t understand what I, as a donor, was getting for my fees.”

Though donors receive a big tax break for donating to donor-advised funds, the funds have no payout requirements, unlike private foundations, which are required to disperse 5 percent of their assets each year. With donor-advised funds, “there’s no urgency and no forced payout,”

he had met wealthy individuals who said they were setting up donor-advised funds so that their children could disperse the funds and learn about philanthropy—they had no intent to spend the money in their own lifetimes.

Fund managers also receive fees for the amount of money they have under management, which means they have little incentive to encourage people to spend the money in their accounts,

Transparency is also an issue. While foundations have to provide detailed information about where they give their money, donor-advised funds distributions are listed as gifts made from the entire charitable fund—like the Silicon Valley Community Foundation—rather than from individuals.

Donor-advised funds can also be set up anonymously, which makes it hard for nonprofits to engage with potential givers. They also don’t have websites or mission statements like private foundations do, which can make it hard for nonprofits to know what causes donors support.

Public charities—defined as organizations that receive a significant amount of their revenue from small donations—were saddled with less oversight, in part because Congress figured that their large number of donors would make sure they were spending their money well, Madoff said. But an attorney named Norman Sugarman, who represented the Jewish Community Federation of Cleveland, convinced the IRS to categorize a certain type of asset—charitable dollars placed in individually named accounts managed by a public charity—as donations to public, not private, foundations.

Donor-advised funds have been growing nationally as the amount of money made by the top 1 percent has grown: Contributions to donor-advised funds grew 15.1 percent in fiscal year 2016, according to The Chronicle of Philanthropy, while overall charitable contributions grew only 1.4 percent that year

Six of the top 10 philanthropies in the country last year, in terms of the amount of nongovernmental money raised, were donor-advised funds,

In addition, those funds with high payout rates could just be giving to another donor-advised fund, rather than to a public charity, Madoff says. One-quarter of donor-advised fund sponsors distribute less than 1 percent of their assets in a year,

Groups that administer donor-advised funds defend their payout rate, saying distributions from donor-advised funds are around 14 percent of assets a year. But that number can be misleading, because one donor-advised fund could give out all its money, while many more could give out none, skewing the data.

Donor-advised funds are especially popular in places like Silicon Valley because they provide tax advantages for donating appreciated stock, which many start-up founders have but don’t necessarily want to pay huge taxes on

Donors get a tax break for the value of the appreciated stock at the time they donate it, which can also spare them hefty capital-gains taxes. “Anybody with a business interest can give their business interest before it goes public and save huge amounts of taxes,”

Often, people give to donor-advised funds right before a public event like an initial public offering, so they can avoid the capital-gains taxes they’d otherwise have to pay, and instead receive a tax deduction. Mark Zuckerberg and Priscilla Chan gave $500 million in stock to the foundation in 2012, when Facebook held its initial public offering, and also donated $1 billion in stock in 2013

Wealthy donors can also donate real estate and deduct the value of real estate at the time of the donation—if they’d given to a private foundation, they’d only be able to deduct the donor’s basis value (typically the purchase price) of the real estate at the time they acquired it. The difference can be a huge amount of money in the hot market of California.